Children's home run by Elizabeth Marland Children’s Respite Care Limited in Trafford

Inspection report children’s home: SC420066 1 SC420066 Registered provider: Elizabeth Marland Children’s Respite Care Limited

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Full inspection Inspected under the social care common inspection framework

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Information about this children’s home

The children’s home is privately owned and provides care for up to eight children who may have a sensory impairment, and/or physical or learning disabilities. The home is registered to care for up to two children under short-break arrangements and a further six children on a permanent basis. The home is also registered with the Care Quality Commission.

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Overall experiences and progress of

children and young people, taking into account

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good

How well children and young people are helped and protected good

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good

The effectiveness of leaders and managers good

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good

The children’s home provides effective services that meet the requirements for good.

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good

Date of last inspection: 31 January 2017

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good

Overall judgement at last inspection: Improved effectiveness

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Enforcement action since last inspection

None Inspection report children’s home: SC420066 2

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Key findings from this inspection

 The home is making a difference to the lives of young people with complex health needs.

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Key findings from this inspection

 Young people’s risks and vulnerabilities are clearly identified and understood by staff.

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Key findings from this inspection

 Staff promote the privacy and dignity of all young people; intimate care needs are managed with the utmost sensitivity.

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Key findings from this inspection

 Observations confirm that young people are safe, happy and settled.

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Key findings from this inspection

 Young people are well cared for by a highly committed staff team which knows them well.

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Key findings from this inspection

 Young people continue to benefit from a nurturing environment that provides them with long-term stability.

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Key findings from this inspection

 Young people, irrespective of any disability they may have, access a range of social, educational and recreational opportunities, including activities in the local community.

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Key findings from this inspection

 Staff are suitably qualified and experienced and use their skills well when caring for children.

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Key findings from this inspection

The children’s home’s areas for development

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Key findings from this inspection

 Staff are not receiving one-to-one supervision each month in line with the home’s policy.

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Key findings from this inspection

 The independent visitor does not routinely consult with parents and relatives, to inform their opinion as to whether young people are safeguarded effectively and whether the conduct of the home promotes their well-being.

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Key findings from this inspection

 Rotas do not reflect the hours the manager spends in the home.

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Key findings from this inspection

 Young people’s plans do not provide clear behaviour management strategies for staff to ensure a consistent approach.

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Key findings from this inspection

 Some young people’s records do not demonstrate that information is consistently recorded in a non-stigmatising way. Inspection report children’s home: SC420066 3

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Inspection date Inspection type Inspection judgement

31/01/2017 Interim Improved effectiveness 06/09/2016 Full Requires improvement 22/03/2016 Interim Sustained effectiveness 26/10/2015 Full Good Inspection report children’s home: SC420066 4

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Statutory requirements

This section sets out the actions that the registered person(s) must take to meet the Care Standards Act 2000, Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. The registered person(s) must comply within the given timescales.

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Requirement Due date

44: Independent person: visits and reports

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Requirement Due date

Reports following independent visits to the home should demonstrate consultation with parents and relatives, which informs their opinion as to whether children are effectively safeguarded and the conduct of the home promotes children’s well-being. (Regulation 44 (2)(a)(4)(a)(b)) 04/07/2017

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Recommendations

 Staff should understand factors that affect children’s motivation to behave in a socially acceptable way. Staff should encourage an enthusiasm for positive behaviour through the use of positive behaviour strategies in line with the child’s relevant plans. (‘Guide to the children’s home regulations including the quality standards’, page 39, paragraph 8.13)

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Recommendations

 Those with a leadership and/or management role should be visible and accessible to staff and able to deliver their leadership and/or management responsibilities. (‘Guide to the children’s home regulations including the quality standards’, page 52, paragraph 10.7)

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Recommendations

 The registered person must have systems in place so that all staff, including the manager, receive supervision of their practice from an appropriately qualified and experienced professional, which allows them to reflect on their practice and the needs of the children assigned to their care. Professionally qualified staff employed by the home, e.g. teachers or social workers, should be provided with relevant professional or clinical supervision by an appropriately qualified and experienced professional. (‘Guide to the quality standards including the children’s home regulations’, page 61, paragraph 13.2)

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Recommendations

 Staff should be familiar with the home’s policies on record keeping and understand the importance of careful, objective and clear recording. Staff should record information on individual children in a non-stigmatising way that Inspection report children’s home: SC420066 5 distinguishes between fact, opinion and third-party information. Information about the child must always be recorded in a way that will be helpful to the child. (‘Guide to the quality standards including the children’s home regulations’, page 62, paragraph 14.4)

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Overall experiences and progress of children and young people: good

Young people have built trusted and secure relationships with key staff who care for them. Staff know each young person well and protect and promote their welfare. Some young people come to stay at the home for short breaks, while four young people have lived together here for a number of years. Staff place the well-being of the young people at the centre of their practice. A member of staff commented, ‘We are very family orientated.’ A professional said, ‘I have been impressed by them [staff]; they work together and engage the young people.’

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Overall experiences and progress of children and young people: good

All young people attend school or college. Staff ensure that young people’s daily routines support their participation and attendance in their education. Members of staff support one young person during his school day; this ensures consistency of care for this young person. Staff spend individual time with young people. For example, a member of staff was observed reading to a young person, while another young person was being supported with their school work.

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Overall experiences and progress of children and young people: good

The home has recently employed the services of a part-time physiotherapist. She is working with the staff and other health professionals to implement programmes that help those young people who have physical disabilities to improve their movement. Adjusting the head-rest on one young person’s wheelchair has meant that the need for frequent oral suction has reduced. She has also delivered training to staff on ‘sleep systems’; this ensures that they are confident in using positioning equipment so that those young people who have difficulty in moving themselves are positioned correctly in bed and sleep well.

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Overall experiences and progress of children and young people: good

Young people enjoy a wide range of stimulating activities that increase their social interactions. For example, two young people attend a weekly freestyle dance group, with one of them recently winning an award for their dancing. In addition, the young person is also taking part in a local dance festival this summer. During the inspection, staff were observed engaging young people in a variety of activities, including arts and crafts, baking, going for walks and playing ball. Another young person is a keen rugby fan and often goes to watch his favourite team when it is playing at home.

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Overall experiences and progress of children and young people: good

Most young people receive good help and support to develop their skills appropriate to their abilities, which may range from personal care tasks to taking their plate to the kitchen at mealtimes. One young person has started using a touch-activated switch machine, which will enable him to operate some electronic equipment independently. This will increase his levels of independence and choice. Inspection report children’s home: SC420066 6 Young people are able to maintain contact with their family and other people who are important to them. Parents and carers are made welcome in the home and family photos are displayed in their bedrooms. This helps to promote their sense of identity. The home is maintained to a good high standard and staff have worked hard to ensure that bedrooms reflect each young person’s personality and individuality.

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How well children and young people are helped and protected: good

Safeguarding training ensures that staff have a good understanding of the protection needs of the young people. This ensures that staff are clear about their safeguarding roles and responsibilities. Staff promote the privacy and dignity of all the young people and their intimate care needs are managed with the utmost sensitivity.

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How well children and young people are helped and protected: good

A number of the young people have life-threatening health conditions. Effective monitoring ensures that the staff are able to respond to any changes in young people’s levels of alertness. In the event of a medical emergency, each young person has a hospital pathway plan that contains essential health information. This ensures that they will receive the most appropriate medical intervention.

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How well children and young people are helped and protected: good

Staff provide young people with high levels of support and supervision because of their vulnerabilities and complex health needs. Consequently, young people are protected from going missing. Staff do not use sanctions or physical interventions to manage young people’s behaviours. Routines and repetitive behaviours are often ways of helping a young person who has autistic spectrum disorder to cope with their day-to- day lives. Observations confirm that most staff are skilled at redirecting individual young people when they are struggling to manage their anxieties. However, young people’s plans do not provide clear behaviour management strategies for staff to ensure a consistent approach. Some records show that on occasions staff use phrases, such as ‘acting up’ or ‘[name] being very badly behaved’ to describe a young person’s distress and upset. This does not ensure that information is recorded in a non-stigmatising way.

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How well children and young people are helped and protected: good

The manager responds effectively to concerns about the welfare and safety of young people. Safeguarding concerns are notified to the appropriate agencies in a timely manner. This ensures that young people are sufficiently safeguarded.

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How well children and young people are helped and protected: good

Young people’s safety is further promoted by the use of detailed risk assessments. A range of health and safety checks ensure that young people live in a safe and secure environment. Staff complete regular checks of equipment, such as bedrails and hoists to ensure that they are in good working order. Furthermore, safe recruitment processes help ensure that staff are safe and suitable. This includes carrying out appropriate checks on sessional workers, such as the physiotherapist.

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The effectiveness of leaders and managers: good

The manager was registered with Ofsted in May 2014 and is also the proprietor of the home. She holds relevant qualifications in management and nursing. The manager is Inspection report children’s home: SC420066 7 assisted by a qualified and experienced clinical matron. The manager and staff team are fully committed to promoting good health and life opportunities for young people with complex health needs.

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The effectiveness of leaders and managers: good

Young people benefit from consistent, nurturing care provided by a stable staff team. The staff have an excellent understanding of each young person’s individual needs. New staff undertake a comprehensive induction to ensure that they are competent to deliver individual healthcare procedures, including gastrostomy feeding and oral suction. A number of the senior care staff are also undertaking a senior practitioner course. This ensures that staff have the right skills and knowledge to meet the needs of the young people.

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The effectiveness of leaders and managers: good

Individual staff said that they are very well supported by the management team. Weekly management meetings and monthly team meetings are driving improvements within the home. That said, staff are not receiving one-to-one supervision each month in line with the home’s policy. This limits their opportunity to reflect on their performance and practice.

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The effectiveness of leaders and managers: good

The home is well resourced and is achieving its aims and objectives as set out in the statement of purpose. The rotas demonstrate that there are sufficient numbers of staff to meet the needs of the young people. However, the duty rosters do not record the hours worked by the manager. This means that there is no accurate record of the hours the manager spends in the home.

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The effectiveness of leaders and managers: good

The monitoring of the quality of care within the home is routinely undertaken by an independent person each month. However, the visitor does not routinely consult with parents and relatives, to inform their opinion as to whether young people are safeguarded effectively and whether the conduct of the home promotes their well- being.

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The effectiveness of leaders and managers: good

The manager has a good understanding of the home’s strengths and weaknesses. The manager undertakes an annual parent audit. The questionnaires seek the opinions of parents and carers on the environment, the well-being of their child, activities and health and nutrition. This enables the manager to continue to improve the service and experiences for the young people. Furthermore, managers complete monthly audits of the young people’s records to ensure that any shortfalls are quickly identified and rectified.

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The effectiveness of leaders and managers: good

The manager has developed effective professional relationships with parents, carers and placing authorities. One carer commented, ‘I can’t fault it [the home]. Staff are very welcoming… they are really friendly… she has lots to talk about when I visit.’ A social worker wrote, ‘[name] is well cared for and I feel they have his best interests at heart and meet his care needs very well.’

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The effectiveness of leaders and managers: good

No requirements or recommendations were made at the last inspection. Inspection report children’s home: SC420066 8

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Information about this inspection

Inspectors have looked closely at the experiences and progress of children and young people. Inspectors considered the quality of work and the difference made to the lives of children and young people. They watched how professional staff work with children and young people and each other and discussed the effectiveness of help and care provided. Wherever possible, they talked to children and young people and their families. In addition, the inspectors have tried to understand what the children’s home knows about how well it is performing, how well it is doing and what difference it is making for the children and young people who it is trying to help, protect and look after.

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Information about this inspection

Using the ‘Social care common inspection framework’, this inspection was carried out under the Care Standards Act 2000 to assess the effectiveness of the service, how it meets the core functions of the service as set out in legislation, and to consider how well it complies with the Children’s Homes (England) Regulations 2015 and the ‘Guide to the children’s homes regulations including the quality standards’. Inspection report children’s home: SC420066 9

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Children’s home details

Registered provider: Elizabeth Marland Children’s Respite Care Limited

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Children’s home details

Responsible individual: Elizabeth Marland

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Inspector

Michelle Bacon, social care regulatory inspector Inspection report children’s home: SC420066 10 achieve excellence in the care of children and young people, and in education and skills for learners of all ages. It regulates and inspects childcare and children’s social care, and inspects the Children and Family Court Advisory and Support Service (Cafcass), schools, colleges, initial teacher training, further education and skills, adult and community learning, and education and training in prisons and other secure establishments. It assesses council children’s services, and inspects services for looked after children, safeguarding and child protection.

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Inspector

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Inspector

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Inspector

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